Selective aortic arch perfusion versus open cardiac massage in exsanguination cardiac arrest: A comparison of coronary pressure dynamics in swine

• Published in: Resuscitation 2021-06, Vol.163, p.1-5
• Main Authors: Edwards, Joseph, Abdou, Hossam, Madurska, Marta J., Patel, Neerav, Richmond, Michael J., Poliner, David, White, Joseph M., Rasmussen, Todd E., Scalea, Thomas M., Morrison, Jonathan J.
• Format: Article
• Language: English
• Subjects: Cardiac massage; Coronary perfusion pressure; Internal massage; Open cardiac massage; SAAP; Selective aortic arch perfusion
• ISSN: 0300-9572; 1873-1570
• DOI: 10.1016/j.resuscitation.2021.04.003

To evaluate the mean aortic-right atrial pressure (AoP-RAP) gradients and mean coronary perfusion pressures (CPPs) observed during open cardiac massage (OCM) versus those obtained with selective aortic arch perfusion (SAAP) in post-mortem hypovolemic swine. Post-mortum, male swine, utilized in prior studies of hemorrhage, were included in the study. Animals were bled ∼25–50% of circulating volume prior to death. Animals either underwent clamshell thoracotomy and OCM immediately after death was confirmed (n = 6) or underwent SAAP within 5−15 min of death (n = 6). Aortic root and right atrial pressures were recorded continuously during each method of resuscitation using solid state blood pressure catheters. Representative five beat samples were extracted; short, similarly timed segments of SAAP were also extracted. Mean AoP-RAP gradient and CPPs were calculated and compared. Mean AoP-RAP gradient and CPP were significantly higher in SAAP animals compared to OCM animals (mean ± SD; 29.1 ± 8.4 vs. 24.5 ± 5.0, p